TuLIP (Tunnelled Line Intraluminal Plasty): An Alternative Technique for Salvaging Haemodialysis Catheter Patency in Fibrin Sheath Formation

Cardiovasc Intervent Radiol. 2019 May;42(5):770-774. doi: 10.1007/s00270-019-02189-7. Epub 2019 Mar 1.

Abstract

Background: Renal patients with a tunnelled haemodialysis line are at risk of fibrin 'sheath' formation which can lead to occlusion. Dysfunctional lines are best treated by catheter exchange with a new subcutaneous tunnel; however, there is a risk of scarring, venous stenosis, potential loss of valuable access as well as the risk of infection.

Method: We report a retrospective review of our experience using tunnelled line intraluminal plasty (TuLIP) in 11 patients over 16 months with fibrin sheath formation on pre-existing tunnelled haemodialysis catheters.

Result: All patients responded well to treatment with median line patency post TuLIP reaching 112 days.

Conclusion: TuLIP may have a role in extending catheter lifespan and delaying more invasive intervention.

Keywords: Fibrin sheath; Haemodialysis catheter; Line stripping.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon / instrumentation
  • Angioplasty, Balloon / methods*
  • Catheters, Indwelling / adverse effects*
  • Equipment Design
  • Feasibility Studies
  • Female
  • Fibrin / adverse effects*
  • Fibrin / metabolism
  • Humans
  • Male
  • Middle Aged
  • Renal Dialysis / adverse effects*
  • Renal Dialysis / instrumentation*
  • Retrospective Studies
  • Salvage Therapy / methods*

Substances

  • Fibrin